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Simple Summary: The conservation of local chicken breeds is globally considered because of their interesting characteristics, such as their tolerance to heat stress, resistance to diseases and capacity to survive in severe environments. In recent years, conservation programs of native chicken breeds have been developed in Italy, and this work has focused on Bionda Piemontese, Bianca di Saluzzo and Pepoi, the first two of which are catalogued as endangered and the third as a 'critically maintained' breed. Semen cryopreservation is the only method that is currently feasible for the ex situ management of genetic diversity in birds, and poultry sperm shows a greater susceptibility during the freezing/thawing process due to its unique features. Therefore, the choice of the most suitable rooster sperm donor is fundamental in the establishment of a semen cryobank. The present study aims to analyze the efficiency of bird and semen management required for the implementation of the Italian Semen Cryobank of Autochthonous Chicken and Turkey Breeds created with the "TuBAvI" project. Our results suggest that male donors need to be selected based on the quality of fresh ejaculates, regardless of sperm outcome after freezing/thawing, in order to identify individuals who can ensure the survival of a breed with regard to increased fertilizing capacity. Native breed conservation is an important component of poultry biodiversity. The aim of this work is to describe different steps that lead to donor selection for the implementation of the Italian Semen Cryobank of Autochthonous Chicken and Turkey Breeds. The variability within and between breeds was evaluated, and the stored semen reproductive capacity was in vivo tested using artificial insemination. Semen from Bionda Piemontese, Bianca di Saluzzo and Pepoi roosters was collected and processed. Concentration, volume, sperm membrane integrity, total motile sperm, progressive motile sperm and kinetic parameters were analyzed; sperm parameters accounting for bird variability were used to select male donors. Fresh semen quality parameters measured in donor ejaculates showed significant differences between breeds; no differences were found after cryopreservation. Variability in the fertilizing ability of cryopreserved semen was found within a breed (5–16%) and between birds within a breed (BP = 3–7%; BS = 7–31%; PP = 6–22%); only sperm quality parameters measured in fresh ejaculates, not frozen/thawed, may be associated with in vivo fertility results. In conclusion, sperm concentration and progressive motility were successfully used as selection parameters to identify chicken male donors with improved sperm quality for sperm cryobanking. However, new reliable sperm markers to predict cryopreserved semen's fertilizing ability are required. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to validate, in an Italian sample, a multidimensional training motivation measure (T-VIES-it) based on expectancy (VIE) theory, and to examine the nomological network surrounding the construct. Design/methodology/approach: Using a cross-sectional design study, 258 public sector employees in Northeast Italy (participating in a range of employer-sponsored training programs) filled out the T-VIES-it and questionnaires on goal orientation, job support for learning, and intention to transfer learning gained through training to the workplace. To validate the T-VIES-it and test its nomological network confirmatory factor analysis and structural equations models were used. Findings: Results showed acceptable confirmatory factor analysis fit indices and psychometric properties of the T-VIES-it. Acceptable fit indexes were also found for the structural equations models tested. The modified model showed significant relations between learning goal orientation and the three dimensions of training motivation; and between the expectancy subscale and job support and intention to transfer. Originality/value: The paper highlights that the T-VIES-it is a validated multidimensional assessment of training motivation, and the first its kind in Italian. The scale should provide value in training evaluations and in research related to training motivation. (Contains 1 note, 2 tables, and 3 figures.)

Purpose: This study aims to examine the organizational socialization of women soldiers in the Italian Army. Design/methodology/approach: Following an interactionist interpretation of socialization, a model was tested to determine the influence of organizational socialization tactics, proactive behaviours, supervisor support on organizational identification, and cohesion of teamwork. This study used a comparative research design. The sample consisted of 324 soldiers, 43 per cent of whom are men and 57 per cent per cent are women. Findings: Structural equation models showed the influences exerted by general socialization and by the acquisition of organizational values/goals on the outcomes of socialization. Multisample analysis showed gender differences. Compared to men, women seemed to set greater value on tutoring by expert colleagues. Women also seemed to value the support provided by their superiors for learning the organizational values and goals on which the degree of identification with the military structure depends. Practical implications: These findings could add new information concerning the organizational socialization strategies (e.g. newcomers' training, tutoring/shadowing programmes) giving some guidelines for the insertion of woman newcomers in a non-traditional organization. Originality/value: In a systemic perspective the present study explored the process of organizational socialization using the content of organizational learning. The research highlighted the gender difference regarding the socialization process in a male-dominated organization. (Contains 6 figures, 3 tables and 2 notes.)

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Respiratory syncytial virus (RSV) is a lead cause of morbidity and hospitalizations in infants. RSV vaccines are currently under development, and preventive options are limited to monoclonal antibodies (mAb). We assessed the knowledge, attitudes and practices for RSV in a sample of general practitioners (GPs) from north-eastern Italy (2021), focusing on the risk perception for infants (age < 8 years) and its potential effectors. We administered an internet survey to 543 GPs, with a response rate of 28.9%. Knowledge status was unsatisfactory, with substantial knowledge gaps found on the epidemiology of RSV and its prevention through mAb. The main effectors of risk perception were identified as having a background in pediatrics (adjusted odds ratio (aOR): 55.398 and 95% confidence interval (95% CI): 6.796–451.604), being favorable towards RSV vaccines when available (aOR: 4.728, 95% CI: 1.999–11.187), while having previously managed an RSV case (aOR: 0.114, 95% CI: 0.024–0.552) and previously recommended hospitalization for cases (aOR: 0.240, 95% CI: 0.066–0.869) were identified as negative effectors. In summary, the significant extent of knowledge gaps and the erratic risk perception, associated with the increasing occurrence in RSV infections, collectively stress the importance of appropriate information campaigns among primary care providers. [ABSTRACT FROM AUTHOR]

The international PRECONNECT Phase IIIb study demonstrated safety and efficacy of trifluridine/tipiracil in the management of patients with metastatic colorectal cancer. Post-hoc analyses in a national context are important because of the differences in disease management across countries. Post-hoc safety and efficacy analyses in the PRECONNECT Italian patient subset were conducted. Patients' quality of life was assessed from baseline to end of treatment. In Italy, 161 patients were enrolled. The median age was 64 years, with a performance status of 0-1. The most common hematological drug-related adverse events ≥grade 3 were neutropenia (41.0%) and anemia (13.7%). The median progression-free survival was reached at 3.0 months, with a disease control rate of 28.6%. The Quality of Life Questionnaire Core 30 score improved in 25.4% of the patients. Safety, efficacy and quality of life results confirmed trifluridine/tipiracil as a feasible and favorable treatment option for metastatic colorectal cancer patients. [ABSTRACT FROM AUTHOR]

Because the working population age is increasing, organizations are struggling to find ways to maintain employees' desire and interest in staying on at work. Accordingly, the aim of this study is to enhance knowledge concerning the role played by personal resources (i.e. work ability) and psychosocial aspects (i.e. older workers stereotypes) in influencing desired retirement age and work engagement in older workers. Data was collected twice, using questionnaires on a sample of 565 older workers working in a public organization in Italy. Specifically, work ability, age stereotypes on older workers and desired retirement age were measured at T1, while work engagement was measured at T2 (eight months later). Using the Preacher and Hayes approach, a moderated mediation analysis was performed controlling for age, self-rated health, expected retirement age, tenure and job position. Results showed that older workers with higher levels of work ability and lower perceptions that in their environment there are age stereotypes, desire to work longer, and in turn stay engaged at work. [ABSTRACT FROM AUTHOR]

GLO:O1P/01oct21:tri13953-fig-0001.jpg PHOTO (COLOR): 1 Time variations of the liver transplant programme activities during the COVID-19 pandemic in 2020. gl We believe our finding of less HCC as an indication for LT during the pandemic to be probably multifactorial. As of 1 December 2020, every wait-listed patient with a previous history of COVID-19 and every newly listed patient is tested for neutralizing COVID-19 antibodies. The COVID-19 emergency has inevitably impacted liver transplantation (LT) activity in the 4 LT programmes operating in Lombardy, the first and worst-hit area of Italy, with 553.854 infected patients and 27.598 deaths as at 10 February 2021 [1,2]. [Extracted from the article]

This paper presents a mass flow model that includes gravity force, material stresses, drag force and topography effects solving a set of hyperbolic partial differential equations by using a so-called depth-averaged technique. The model is non-linear and general enough to tackle various problems of interest for geophysics and environmental engineering, such as the dynamic evolution of flow-like avalanches, the dam break problem (involving only water flow) and the generation of tsunami waves by landslides. The model is based on a Eulerian fluid solver, using a second-order central scheme with a minmod-like limiter; is tested against a number of typical benchmark cases, including analytical solutions and experimental laboratory data; and also compared with other numerical codes. Through this model, we study a historical tsunamigenic event occurred in 1783 in Scilla, Italy, that resulted to be catastrophic with a toll exceeding 1500 fatalities. The landslide is reconstructed by a mixture debris flow, and results are compared with the observational data and other numerical simulations. [ABSTRACT FROM AUTHOR]

The 1783 Scilla tsunami, induced by a coastal landslide occurring during an intense seismic sequence in Calabria (South Italy), was one of the most lethal ever observed in Italy. It caused more than 1500 fatalities, most of which on the 10 beach close to the town where people gathered to escape earthquake shaking. In this paper, complementing a previous work (Zaniboni et al., 2016) focusing on the very local tsunami effects in the town of Scilla, we study the tsunami impact on the Calabria and Sicily coasts out of Scilla. To this purpose we take into account the same landslide geometry considered in the previous study and perform three tsunami simulations, one embracing a larger region with a 50-m computational grid, and two covering the specific area of Capo Peloro, in Sicily, facing Scilla on the western side of the Messina Straits, with even 15 higher resolution (10 m mesh). Numerical results show a very good agreement with the historical observations in Capo Peloro. Moreover, the resulting global tsunami inundation pattern provides a useful hint for tsunami hazard assessment in the Messina Straits area, which is known to be one of the most exposed to tsunami threat in Italy and in the Mediterranean Sea. [ABSTRACT FROM AUTHOR]

Eastern Sicily is affected by earthquakes and tsunamis of local and remote origin, which is known through numerous historical chronicles. Recent studies have put emphasis on the role of submarine landslides as the direct cause of the main local tsunamis, envisaging that earthquakes (in 1693 and 1908) did produce a tsunami, but also that they triggered mass failures that were able to generate an even larger tsunami. The debate is still open, and though no general consensus has been found among scientists so far, this research had the merit to attract attention on possible generation of tsunamis by landslides off Sicily. In this paper we investigate the tsunami potential of mass failures along one sector of the Hyblean-Malta Escarpment (HME). facing Augusta. The HME is the main offshore geological structure of the region running almost parallel to the coast, off eastern Sicily. Here, bottom morphology and slope steepness favour soil failures. In our work we study slope stability under seismic load along a number of HME transects by using the Minimun Lithostatic Deviation (MLD) method, which is based on the limit-equilibrium theory. The main goal is to identify sectors of the HME that could be unstable under the effect of realistic earthquakes. We estimate the possible landslide volume and use it as input for numerical codes to simulate the landslide motion and the consequent tsunami. This is an important step for the assessment of the tsunami hazard in eastern Sicily and for local tsunami mitigation policies. It is also important in view of tsunami warning system since it can help to identify the minimum earthquake magnitude capable of triggering destructive tsunamis induced by landslides, and therefore to set up appropriate knowledge-based criteria to launch alert to the population. [ABSTRACT FROM AUTHOR]

The seismic crisis that hit Calabria (South Italy) since the beginning of 1783, lasted 3 years with strong earthquakes concentrated in the first 2 months, causing many fatalities and great destruction, as reported by several detailed historical reports. Following an earthquake that occurred on February 6, 1783, a mass with volume of about 6 Mm detached from the flank of Mount Pacì and collapsed into the sea. In 1 min, huge waves attacked the nearby village of Scilla and killed most of the people that had gathered in the wide shore named Marina Grande to escape from seismic danger. More than 1500 people died due to the tsunami, many buildings were destroyed. In the paper, such catastrophic event is studied by means of numerical models. First we reconstruct the initial sliding mass and compute its motion through a Lagrangian model; then, we simulate the tsunami generation, propagation and flooding on the coast of Scilla by means of a nonlinear shallow-water equations model. The results of the simulation are compared against the detailed description of the tsunami effects available from several historical accounts and are found to be in a very satisfactory agreement with the 6-8 m inundation height reported in the Marina Grande beach. [ABSTRACT FROM AUTHOR]

By taking advantage of the Italian protest in 2009 in reaction to the behaviour of then Prime Minister Berlusconi, in this research, we investigated the role of sexist beliefs (i.e., hostile sexism, complementary gender differentiation, protective paternalism, and heterosexual intimacy) and group-based emotional reactions (i.e., anger, humiliation, and sadness) to women's and men's action mobilization against public forms of sexism. The findings of this study suggest that women and men engaged in this protest for different reasons. Women mobilized to express their anger at Berlusconi's sexist behaviour, an emotion related to the condemnation of hostile sexist views and benevolent sexist beliefs about heterosexual intimacy. In contrast, the strength of men's participation in the protest was affected by humiliation, an emotion related to the condemnation of hostile sexist beliefs and support for complementary gender differentiation. This emotional path suggests that men likely protested to restore their reputations. These findings underline the role of sexist beliefs and group-based emotions in transforming the condemnation of a sexist event into action mobilization against sexism for both women and men. [ABSTRACT FROM AUTHOR]

Coastal tide gauges play a very important role in a tsunami warning system, since sea-level data are needed for a correct evaluation of the tsunami threat, and the tsunami arrival has to be recognized as early as possible. Real-time tsunami detection algorithms serve this purpose. For an efficient detection, they have to be calibrated and adapted to the specific local characteristics of the site where they are installed, which is easily done when the station has recorded a sufficiently large number of tsunamis. In this case the recorded database can be used to select the best set of parameters enhancing the discrimination power of the algorithm and minimizing the detection time. This chance is however rare, since most of the coastal tide-gauge stations, either historical or of new installation, have recorded only a few tsunamis in their lifetimes, if any. In this case calibration must be carried out by using synthetic tsunami signals, which poses the problem of how to generate them and how to use them. This paper investigates this issue and proposes a calibration approach by using as an example a specific case, which is the calibration of a real-time detection algorithm called TEDA (Tsunami Early Detection Algorithm) for two stations (namely Tremestieri and Catania) in eastern Sicily, Italy, which were recently installed in the frame of the Italian project TSUNET, aiming at improving the tsunami monitoring capacity in a region that is one of the most hazardous tsunami areas of Italy and of the Mediterranean. [ABSTRACT FROM AUTHOR]

Abstract: Local chicken breeds are a vital reservoir of gene resources and their conservation has a technical role related to the future development of the productive system, as well as a social-cultural role. The aim of this study was to evaluate the effects of egg weight, egg storage period and egg weight loss on hatchability of fertile eggs in the Italian bantam breed Mericanel della Brianza. Fourteen females and eight males were kept in floor pens and divided in 8 families (1M:1 or 2F) during the reproductive season (March–June). Birds received a photoperiod of 14L:10D and were fed ad libitum. Egg production and egg weight were recorded daily. Eggs were divided in 4 weight groups: EW1=<33g, EW2=33–36g, EW3=36–39g and EW4=≥39g. Eggs were stored at 18°C and classified in 3 egg storage groups: ES1=0–4, ES2=5–9 and ES3=10–15 days. Egg weight loss was recorded and distributed in 5 different classes: EWL1=<10%, EWL2=10–15%, EWL3=16–20%, EWL4=21–25%, EWL5=>25%. Fertility, embryo mortality and hatchability were recorded. The mean values during the reproductive season were 82% fertility and 50% hatchability of fertile eggs. The best combination of fertility and hatchability values were recorded in EW2 and lower fertility was recorded in EW1 (P <0.05). Hatchability decreased under 50% after 10 day storage period before incubation and the best hatchability was recorded in EWL1. The present results contribute to the knowledge on reproductive parameters necessary to improve the reproductive efficiency of this Italian breed within a conservation plan. [Copyright &y& Elsevier]

Objective: The purpose of this study was to enhance understanding of the impact of individual and environmental variables on job satisfaction among people with severe mental illness employed in social enterprises. Participants: A total of 248 individuals with severe mental illness employed by social enterprises agreed to take part in the study. Methods: We used logistic regression to analyse job satisfaction. A model with job satisfaction as the dependent variable, and both individual (occupational self-efficacy and severity of symptoms perceived) and environmental (workplace) factors (provision of workplace accommodations, social support from co-workers, organizational constraints) as well as external factors (family support) as predictors, was tested on the entire sample. Results: All findings across the study suggest a significant positive impact of both individual and environmental factors on job satisfaction. People with higher occupational self-efficacy who were provided with workplace accommodations and received greater social support were more likely to experience greater job satisfaction. Conclusions: These results suggest that certain features of social enterprises, such as workplace accommodations, are important in promoting job satisfaction in people with severe mental illness. Further studies are warranted to expand knowledge of the workplace features that support employees with severe mental illness in their work integration process. [ABSTRACT FROM AUTHOR]

South-eastern Sicily has been affected by large historical earthquakes, including the 11 January 1693 earthquake, considered the largest magnitude earthquake in the history of Italy (Mw =7.4). This earthquake was accompanied by a large tsunami (tsunami magnitude 2.3 in the Murty- Loomis scale adopted in the Italian tsunami catalogue by Tinti et al., 2004), suggesting a source in the near offshore. The fault system of the eastern Sicily slope is characterised by NNW--SSE-trending east-dipping extensional faults active in the Quaternary. The geometry of a fault that appears currently active has been derived from the interpretation of seismic data, and has been used for modelling the tsunamigenic source. Synthetic tide-gauge records from modelling this fault source indicate that the first tsunami wave polarity is negative (sea retreat) in almost all the coastal nodes of eastern Sicily, in agreement with historical observations. The outcomes of the numerical simulations also indicate that the coastal stretch running from Catania to Siracusa suffered the strongest tsunami impact, and that the highest tsunami waves occurred in Augusta, aslo in agreement with the historical accounts. A large-size submarine slide (almost 5 km3) has also been identified along the slope, affecting the footwall of the active fault. Modelling indicates that this slide gives non-negligible tsunami signals along the coast; though not enough to match the historical observations for the 1693 tsunami event. The earthquake alone or a combination of earthquake faulting and slide can possibly account for the large run up waves reported for the 11 January 1693 event. [ABSTRACT FROM AUTHOR]

Objective: Social Enterprises (SEn) are innovative companies that help disadvantaged people (e.g., individuals with mental disorders) with the work integration process. This study explores the working plan patterns of people with mental disorders employed in SEn. Methods: A cross-sectional design was adopted. One hundred and forty individuals with mental disorders employed in 19 Italian SEn filled out a battery of questionnaires. Results: We identified three patterns of working plans: Cluster 1 (n = 39, 30%) showed a stronger intention to work in a competitive labor market; Cluster 2 (n = 16, 12.3%) showed a stronger intention to stop working; Cluster 3 (n = 75, 57.7%) showed a stronger intention to continue working at a SEn. Conclusions and Implications for Practice: Most of the sample had a pattern of intentions to keep working, thereby demonstrating the effectiveness of the SEn approach to work integration. Future studies should explore the approach further. Indeed, these results seem important for implications for practice, suggesting that people with mental disorders inside SEn can improve their level of interpersonal skills and reinforce their vocational identity, and ultimately increase their chances of employment in the regular labor market. [ABSTRACT FROM AUTHOR]

Eastern Sicily is one of the coastal areas most exposed to earthquakes and tsunamis in Italy. The city of Catania that developed between the eastern base of Etna volcano and the Ionian Sea is, together with the neighbour coastal belt, under the strong menace of tsunamis. This paper addresses the estimation of the tsunami hazard for the city of Catania by using the technique of the Worst-case Credible Tsunami Scenario Analysis (WCTSA) and is focused on a target area including the Catania harbour and the beach called La Plaia where many human activities develop and many important structures are present. The aim of the work is to provide a detailed tsunami hazard analysis, firstly by building scenarios that are proposed on the basis of tectonic considerations and of the largest historical events that hit the city in the past, and then by combining all the information deriving from single scenarios into a unique aggregated scenario that can be viewed as the worst virtual scenario. Scenarios have been calculated by means of numerical simulations on computational grids of different resolutions, passing from 3 km on a regional scale to 40 m in the target area. La Plaia beach results to be the area most exposed to tsunami inundation, with inland penetration up to hundreds of meters. The harbout turns out to be more exposed to tsunami waves with low frequencies: in particular, it is found that the major contribution to the hazard in the harbour is due to a tsunami from a remote source, which propagates with much longer periods than tsunamis from local sources. This work has been performed in the framework of the EU-funded project SCHEMA. [ABSTRACT FROM AUTHOR]

The island of Ischia, Gulf of Naples, Italy, like many other volcanic islands is affected by mass failures, that are mainly related to secondary volcanic processes such as slope steepening and seismic shaking. The block resurgence of its main relief, Mount Epomeo, has been recognised to contribute cyclically to mass instability and cause landslides, that occasionally may reach the sea and start tsunamis. In this work we explore the consequences of the Ischia Debris Avalanche (IDA), a flank collapse that occurred in historical times, and involved the whole Mount Epomeo edifice including its submarine portion, and that may have caused gigantic sea waves affecting all the coasts of Ischia and of the Gulf of Naples. The IDA and the generated tsunami have been taken as the worst-case scenario for the occurrence of a new tsunami in the area. They have been simulated through numerical codes developed and maintained by the University of Bologna. The simulation shows that the IDA-induced tsunami attacks severely all the coasts of the Gulf of Naples with the highest waves obtained for the island of Ischia, the island of Capri and the peninsula of Sorrento. The propagation pattern of the IDA tsunami can be used to get hints on the impact that such an event may have had on early populations habiting Gulf of Naples, but also to get clues on the area that could be most severely hit by a tsunami generated by a smaller-scale landslide that may occur in the same source zone. [ABSTRACT FROM AUTHOR]

Purpose -- This study aims to explore the psycho-social factors (i.e. older worker identity, development opportunities on the job, anticipation of lost social integration upon retirement) related to three types of retirement intention (i.e. full retirement, part-time retirement, job mobility). Design/methodology/approach -- A representative sample of 196 workers aged 50 and over employed in an Italian public-sector organization completed a research questionnaire. Hypotheses were tested by using structural equation models. Findings -- The results showed that: the older-worker identity was related positively to full retirement intention and negatively to job mobility; development opportunity on the job was negatively related to the full retirement intention; the anticipation of lost social integration upon retirement was positively related to the intention to take part-time retirement and job mobility. Research limitations/implications -- There are several limitations to the study: the cross-sectional design; use of single items; the fact that the findings can be generalized only to the organization in which the study was conducted. Practical implications -- Retirement preparation programs should consider the various factors that affect the transition from work to retirement and which may facilitate prior planning by both the individual and the organization. Originality/value -- Expanding previous research studies, the study considers the complexity of preparation for retirement transition by exploring different types of retirement intentions and the psychosocial factors related to them. [ABSTRACT FROM AUTHOR]

Not many studies regarding comfort in physiotherapy centers are present in literature. These facilities host both therapists and patients, who can have different age and health status and perform different activities. For this reason, the assessment of indoor environment can be difficult, and models available in technical standards and in the literature may poorly represent the occupants of physiotherapy centers. In this study, environmental well-being of therapists and patients was analysed in two facilities located in Italy and Denmark, in terms of thermal comfort and its interaction with other environmental quality domains (visual, air quality, acoustic). Separately for the heating and non-heating periods, measurements of the physical quantities and subjective questionnaire surveys were applied. Fanger's and adaptive models were used, while the influence of metabolic rate and subjective parameters on thermal comfort of occupants was investigated with statistical analyses. The neutral temperatures of the different occupants were assessed by means of different methods, and statistical analyses allowed to study the interaction of thermal comfort with the other domains. The study highlighted: 1. Limitations of current thermal comfort models when used in physiotherapy centers, being the metabolic rate difficult to estimate and subjective thermal sensation and satisfaction dependent on subjective parameters not included in the models (type of occupant, age, health status and gender); 2. Unsuitability of linear regression for estimating the neutral temperatures; 3. High tolerance and adaptability of therapists and patients to the temperatures in both seasons; 4. Association of thermal satisfaction with satisfaction with other environmental parameters. • Thermal comfort and its interaction with other IEQ domains was studied in two physiotherapy centers. • Subjective factors and variability of metabolic rate make field studies necessary to study comfort. • Approaches more complex than linear regression are necessary to assess neutral temperature. • Higher neutral temperatures during summer are due to adaptation only in case of dynamic therapies. • Issues with other IEQ domains influence the thermal satisfaction. [ABSTRACT FROM AUTHOR]

Stromboli is an Italian volcanic island known for its persistent state of activity, which leads to frequent mass failures and consequently to frequent tsunamis ranging from large (and rare) catastrophic events involving the entire southern Tyrrhenian Sea to smaller events with, however, extremely strong local impact. Most of tsunamigenic landslides occur in the Sciara del Fuoco (SdF) zone, which is a deep scar in the NW flank of the volcano, that was produced by a Holocene massive flank collapse and that is the accumulation area of all the eruptive ejecta from the craters. Shallow-water bathymetric surveys around the island help one to identify submarine canyons and detachment scars giving evidence of mass instabilities and failures that may have produced and might produce tsunamis. The main purpose of this paper is to call attention to tsunami sources in Stromboli that are located outside the SdF area. Further, we do not touch on tsunami scenarios associated with gigantic sector collapses that have repeat times in the order of several thousands of years, but rather concentrate on intermediate size tsunamis, such as the ones that occurred in December 2002. Though we cannot omit tsunamis from the zone of the SdF, the main emphasis is on the elaboration of preliminary scenarios for three more possible source areas around Stromboli, namely Punta Lena Sud, Forgia Vecchia and Strombolicchio, with the aim of purposeful contributing to the evaluation of the hazard associated with such events and to increase the knowledge of potential threats affecting Stromboli and the nearby islands of the Aeolian archipelago. The simulations show that tsunami sources outside of the SdF can produce disastrous effects. As a consequence, we recommend that the monitoring system that is presently operating in Stromboli and that is focussed on the SdF source area be extended in order to cover even the other sources. Moreover, a synoptic analysis of the results from all the considered tsunami scenarios leads to a very interesting relation between the tsunami total energy and the landslide potential energy, that could be used as a very effective tool to evaluate the expected tsunami size from estimates of the landslide size. [ABSTRACT FROM AUTHOR]

On 30 December 2002 the coast of the volcanic island of Stromboli, in the Tyrrhenian sea, Italy, was attacked by two tsunamis generated by landslides that took place on the north-west flank of the volcano. The landslides and the tsunamis represented the most impressive and threatening episodes of a strong effusive eruption, started on 28 December from a new vent which opened close to the north-east crater of the volcano. In spite of the intensified monitoring carried out in response to the eruption, the landslides and the ensuing tsunamis were not foreseen, and the available instrumental data are insufficient to allow a precise reconstruction of the sequence of the events. The seismic network recorded two main landslides along the steep slope of Sciara del Fuoco, with onset around 13:15 and 13:23 local time (GMT+1). The tsunamis were the direct consequence of the mass movements. Three main post-event surveys helped make assessment on the wave impact on the coast. In this paper the attention is focussed on the accounts of the eye-witnesses, that help us clarify and understand what happened. People in the source area (Sciara del Fuoco) reported a small-volume subaerial slide taking place first, then a sharp cut forming in the sea water down to the sea floor (about 10-20m deep) and propagating almost parallel to the coastline, be concomitantly associated with a sea retreat and a subsequent sea advance. It is suggested here that the cut was the effect of a large submarine landslide that detached from very close to the coast and produced the 13:15 signal in the recorded seismograms. The second, mostly subaerial, slump was observed to slide down 7-8 min later and to excite a train of waves some distance offshore. Not all the witnesses realised that two distinct tsunamis occurred. The tsunami period was probably in the order of 100 s, but shorter period crests were seen to travel on the top of the long-period waves by several persons. The duration of each tsunami was appreciated to be around 5-7 min. It is difficult to ascertain which tsunami was the largest, since there is no full agreement among the observers, but certainly by accounts both were characterised by large destructive waves. [ABSTRACT FROM AUTHOR]

Simple Summary: The ongoing loss of domestic animal breeds around the world is occurring at an alarming rate. Thus, the registration and preservation of native breeds is of great importance. The aim of this study, which forms part of a conservation program, was to provide an overview of the conservation statuses of native Italian poultry breeds being reared by local breeders in Italy. The data collected by means of a census questionnaire demonstrate the low population sizes of these breeds in Italy and highlight the need for campaigns aimed at publicizing and promoting the benefits of native breeds with the goal of increasing population sizes. Identifying strategies to facilitate breeders' access to pure breed birds is also essential, and would require collaborative efforts of university research centers, public entities, and breeders. The most reared species of farm animal around the world is the chicken. However, the intensification of livestock systems has led to a gradual increase in the concentration of a limited number of breeds, resulting in substantial erosion to the genetic pool. The initial step of an 'animal conservation program' entails establishing the actual conservation statuses of the breeds concerned in a defined area; in this case, in Italy. To this end, a survey of breeds was performed by means of a census questionnaire divided into two parts. The first part collected information on breeds, breeders, housing facilities, and management aspects, the results of which are presented here. The second part of the questionnaire regarded chicken products and their markets, and these data will be reported in a second paper. The breed status of six chicken breeds was shown to be exceptionally worrying, with total numbers ranging from just 18 to 186 birds. Population sizes exceeding 1000 birds was identified for just four breeds, the maximum being 3400. Some improvements in status were noted in relation to breeds which had been the subject of conservation efforts in the past. The two most common breeds reported are the Bionda Piemontese, a double-purpose breed, and the Livorno egg-laying hen. Collo Nudo Italiano, Millefiori Piemontese, Pollo Trentino, and Tirolese chicken breeds and the Castano Precoce turkey breed were not listed by breeders at all. The most reported turkey breeds are the Bronzato Comune and the Ermellinato di Rovigo. The population sizes of native Italian poultry breeds were shown to be generally poor. Italian poultry farmers and the population at large are largely ignorant about indigenous poultry breeds. Thus, promoting the virtues of Italian breeds would help their conservation by encouraging breeders to rear these birds and consumers to buy their products. The identification of strategies to facilitate access to pure breed birds is essential, and will require the collaboration of university research centers, public entities, and breeders. The results presented in this paper constitute the initial part of a more complex conservation program. [ABSTRACT FROM AUTHOR]

The recent outbreak of Covid-19 has represented a major challenge for the countries affected by the disease, not only in terms of loss of human life, economic downturn, and constraint on individual freedom, but also for the great pressure on the national health systems and hospitals. The 380 kDa virus has been a perfect storm, especially for those national health systems used to working with limited resources and high intensity rhythms, such as Italy. For the first time in the new century, a virtually unknown fast-spreading disease has caused a public health emergency thus forcing most countries to deal with an insurmountable logistic gap. Hence, every branch of Medicine, even though not directly involved in the treatment, has been called upon to provide its contribution to resolve the crisis. It is now becoming more apparent that Covid-19 is not solely a lung disease, but a complex systemic disease involving several organs and systems. This is due to an abnormal inflammatory response which eventually leads to multisystemic coagulopathy which mainly, but not uniquely, targets the lungs. Although the pathophysiology of this syndrome is still not fully understood, macrophages and their immune complex system seem to play a key role. It is not yet clear why some patients develop the violent immune response which results in pneumonitis while others do not. There are clues indicating that the systemic hyper-inflammation defined as macrophage activation syndrome (MAS), or cytokine storm, requires an increase in choline consumption to synthesize phosphatidylcholine and stimulate phagocytosis, organelle biogenesis, secretory functions, and endocytosis. 18F-Fluorocholine is a synthetic analog of the naturally occurring choline normally used for PET/CT imaging of prostate cancer patients. 18F-Fluorocholine could image and quantify the macrophage activity in pulmonary interstitial infiltrates of Covid-19 pneumonia. If the hypothesis is confirmed experimentally, 18F-Fluorocholine PET/CT could be used to in vivo image and quantify the degree of lung inflammation and potentially stratify the gravity of this disease. [ABSTRACT FROM AUTHOR]

Objective: People with mental illnesses face stigma that hinders their full integration into society. Work is a major determinant of social inclusion, however, people with mental disorders have fewer opportunities to work. Emerging evidence suggests that social enterprises help disadvantaged people with their work integration process. The purpose of this study is to enhance our understanding about how perceptions of stigma can be decreased for people with mental disorders throughout their work experience in a social enterprise. Method: Using a longitudinal study design, 310 individuals with mental disorders employed in Italian social enterprises completed a battery of questionnaires on individual (e.g., severity of symptoms; occupational self-efficacy) and environmental (e.g., social support; organizational constraints) variables. Of the 223 individuals potentially eligible at the 12-month follow up, 139 completed a battery of questionnaires on social and working skills, perceived work productivity and perceived stigma. Path analyses were used to test a model delineating how people with mental disorders working in social enterprises improve social and work outcomes (i.e., motivation, skills and productivity), and reduce the perception of being stigmatized. Results: Working in a social enterprise enhances working social skills, which leads to a perception of higher productivity and, consequently, the perception of being discriminated against and stigmatized is reduced. Conclusions and Implications for Practice: Social enterprise provides a context in which people with mental disorders reach a sense of work-related and social competence. This sense of competence helps them to reduce perceived stigma, which is a crucial step toward social inclusion. [ABSTRACT FROM AUTHOR]

Oxaliplatin-based adjuvant chemotherapy is the standard treatment of high-risk colon cancer (CC). A shorter duration (3 months) can achieve a similar outcome [in terms of relapse-free survival (RFS)] to a longer duration. This study reports the overall survival (OS) analysis of the three or six colon adjuvant (TOSCA) phase III study. It assessed different adjuvant chemotherapy durations in patients with resected high-risk stage II and stage III CC. TOSCA was an open-label, phase III, multicentre, non-inferiority trial conducted in 130 Italian centres. Patients were randomly assigned, in a 1 : 1 ratio, to receive 3 months of standard doses of FOLFOX/CAPOX, or 6 months of FOLFOX/CAPOX. Patients with histologically confirmed high-risk stage II and III CC were included, with RFS being the primary end point. OS was a secondary end point. From June 2007 to March 2013, 3759 patients were accrued. At a median follow-up of 7 years, the hazard ratio (HR) for RFS of the 3-month versus 6-month arms was 1.13; 95% confidence interval (CI) 0.99-1.29, P for non-inferiority = 0.380, P for superiority = 0.068, crossing the non-inferiority limit of 1.20. This result did not allow us to reject the null hypothesis of the inferiority of the 3-month arm. The HR for OS of the 3-month versus 6-month arms was 1.09 (95% CI 0.93-1.26, P for superiority = 0.288). At the last follow-up analysis, the absolute OS difference between arms was <1%. The present analysis of the TOSCA trial does not indicate any significant difference in OS between the treatment groups. The extra benefit provided by the longer treatment should be balanced against the extra toxicity of more prolonged therapy. The trial is registered with ClinicalTrials.gov , registration number: NCT0064660. • TOSCA trial compared 3 or 6 months of adjuvant chemotherapy. • We here provided the updated results of OS at 7 years of median follow up. • The HR for OS of the 3-month versus 6-month arms was 1.09 (95% CI 0.93-1.26, P for superiority = 0.288). • At the last follow-up analysis, the absolute OS difference between arms was <1%. • The present analysis of the TOSCA trial does not indicate any significant difference in OS between the treatment groups. [ABSTRACT FROM AUTHOR]

The Milanino is an Italian chicken breed included in a conservation project run by the University of Milan. It is characterized by good fertility, heavy body weights, high adaptation ability to adverse climate conditions, and disease resistance. Because of these characteristics, the Milanino could represent an important genetic resource for alternative production systems. This research was aimed at studying the effect of bird density on growth and slaughter performance, as well as stress response in Milanino chickens kept in outdoor pens. One hundred and sixty Milanino chickens were randomly assigned to 2 experimental groups kept at different densities (2 m²/bird and 8 m²/bird) and were slaughtered at 185 days of age. Growth and slaughter performance and stress condition were recorded. The interaction bird density * sex * age significantly affected body weight and an opposite trend was found between females and males: heavier females were found in the high-density group, while heavier males were found in the low-density group. Bird density did not affect carcass weight data. The stress marker (H/L ratio) was significantly higher in birds kept at the higher density (2 m²/bird). In conclusion, the Milanino provided satisfactory growth performance with different rearing density but the lower density, 8 m²/bird, should be preferred to minimize welfare problems for male birds. [ABSTRACT FROM AUTHOR]

Background: In the TRIBE study, FOLFOXIRI (fluorouracil, leucovorin, oxaliplatin, and irinotecan) plus bevacizumab significantly improved progression-free survival of patients with metastatic colorectal cancer compared with FOLFIRI (fluorouracil, leucovorin, and irinotecan) plus bevacizumab. In this updated analysis, we aimed to provide mature results for overall survival-a secondary endpoint-and report treatment efficacy in RAS and BRAF molecular subgroups.Methods: TRIBE was an open-label, multicentre, phase 3 randomised study of patients (aged 18-70 years with Eastern Cooperative Oncology Group [ECOG] performance status of 2 or less and aged 71-75 years with an ECOG performance status of 0) with unresectable metastatic colorectal cancer who were recruited from 34 Italian oncology units. Patients were randomly assigned (1:1) via a web-based procedure to receive FOLFIRI plus bevacizumab or FOLFOXIRI plus bevacizumab. Bevacizumab was given as a 5 mg/kg intravenous dose. FOLFIRI consisted of a 180 mg/m(2) intravenous infusion of irinotecan for 60 min followed by a 200 mg/m(2) intravenous infusion of leucovorin for 120 min, a 400 mg/m(2) intravenous bolus of fluorouracil, and a 2400 mg/m(2) continuous infusion of fluorouracil for 46 h. FOLFOXIRI consisted of a 165 mg/m(2) intravenous infusion of irinotecan for 60 min, followed by an 85 mg/m(2) intravenous infusion of oxaliplatin given concurrently with 200 mg/m(2) leucovorin for 120 min, followed by a 3200 mg/m(2) continuous infusion of fluorouracil for 48 h. Tissue samples for RAS and BRAF mutational status analyses were centrally collected. In this updated analysis, we assessed the secondary endpoint of overall survival in the main cohort and treatment efficacy in RAS and BRAF molecular subgroups. All analyses were by intention to treat. TRIBE was concluded on Nov 30, 2014. The trial is registered with ClinicalTrials.gov, number NCT00719797.Findings: Between July 17, 2008, and May 31, 2011, 508 patients were randomly assigned. At a median follow-up of 48·1 months (IQR 41·7-55·6), median overall survival was 29·8 months (95% CI 26·0-34·3) in the FOLFOXIRI plus bevacizumab group compared with 25·8 months (22·5-29·1) in the FOLFIRI plus bevacizumab group (hazard ratio [HR] 0·80, 95% CI 0·65-0·98; p=0·03). Median overall survival was 37·1 months (95% CI 29·7-42·7) in the RAS and BRAF wild-type subgroup compared with 25·6 months (22·4-28·6) in the RAS-mutation-positive subgroup (HR 1·49, 95% CI 1·11-1·99) and 13·4 months (8·2-24·1) in the BRAF-mutation-positive subgroup (HR 2·79, 95% CI 1·75-4·46; likelihood-ratio test p<0·0001). Treatment effect was not significantly different across molecular subgroups (pinteraction=0·52).Interpretation: FOLFOXIRI plus bevacizumab is a feasible treatment option for those patients who meet the inclusion criteria of the present study, irrespective of baseline clinical characteristics and RAS or BRAF mutational status. [ABSTRACT FROM AUTHOR]

There have been anecdotal reports of an association between coeliac disease and epilepsy with cerebral calcifications that resemble those of the Sturge-Weber syndrome. A series of patients who had epilepsy with calcifications, in whom coeliac disease (CD) was incidentally observed, prompted us to study this association. 43 patients (15 male, age range 4.6-30.7 years) were selected from two series. 31 patients with cerebral calcifications of unexplained origin and epilepsy (series A) underwent intestinal biopsy. 12 patients with CD and epilepsy (series B) underwent computed tomography. Antibodies to gluten, folic acid serum concentrations, were measured, and HLA typing was done in most patients. 24 of the series A patients were identified as having CD on the basis of a flat intestinal mucosa (15/22 with a high concentration of serum antigluten), and 5 series B patients showed cerebral calcifications, giving a total of 29 cases with the combination of CD, epilepsy, and cerebral calcifications (CEC). In 27 of these CEC patients, calcifications were located in the parieto-occipital regions. Only 2 of the series A patients had gastrointestinal symptoms at the time of intestinal biopsy; most patients had recurrent diarrhoea, anaemia, and other symptoms suggestive of CD in the first 3 years of life. The epilepsy in CEC patients was poorly responsive to antiepileptic drugs. Gluten-free diet beneficially affected the course of epilepsy only when started soon after epilepsy onset. Cases of "atypical Sturge-Weber syndrome" (characterised by serpiginous cerebral calcifications and epilepsy without facial port-wine naevus) should be reviewed, and CD should be ruled out in all cases of epilepsy and cerebral calcifications of unexplained origin. [ABSTRACT FROM AUTHOR]

The Palinuro volcanic chain (PVC) is located about 80 km offshore the Campania region (Italy) in the southern sector of the Tyrrhenian Sea. The chain consists of 15 volcanic edifices aligned in an E-W direction with two distinct major seamounts (Palinuro and Glabro). They cover a 90 km long and 20 km wide area, with a present-day volume of 2700 km3. Palinuro volcanism emplaced between 0.8 and 0.3 Ma, although shallow seismicity and hydrothermalism indicate an ongoing volcanic activity. A geomorphological analysis of the volcanic chain and data from a multichannel seismic profile reveal large volumes of buried chaotic material suggesting gravity mass sliding from the volcano flanks and slide scars. A stability analysis of the Palinuro flanks has been carried out to determine the sectors potentially prone to sliding in case of shallow volcanic earthquakes. Landslides are simulated by adopting a scenario-based approach. Tsunamis induced by these mass movements and their propagation across the Tyrrhenian Sea are modeled. Results suggest that shallow earthquakes (M ~4.6–4.8) are able to destabilize the flanks of the volcanic chain generating slope failures. Sliding volumes in the order of 1.5 km3 and 2.4 km3 may induce waves as high as 1.5 and 6 m, respectively, along the peri-Tyrrhenian coast. Our results underline the need for further investigations on the stability of the submarine volcanoes of the Tyrrhenian basin. These volcanoes are still poorly known although their instability could trigger large tsunamis along the southern Italy coastal sectors. Our recommendation is that multiparamertic monitoring networks on PVC and periodic oceanic cruises should be put into action, and further that a systematic evaluation of the tsunami hazard related to possible sliding phenomena on the flanks of the Tyrrhenian seamounts should be performed. • A stability analysis on the Palinuro volcanic chain (Italy) revealed its weakest sectors in case of volcanic earthquakes. • Landslides scenarios have been simulated on the three most unstable sections found. • Tsunami generation and propagation have been evaluated as a consequence of these different-size submarine movements. • Two out of three events generate waves potentially hazardous for specific coastal sections of the southern Tyrrhenian Sea. • The study highlights the need for further investigations and monitoring of the numerous Tyrrhenian Seamounts. [ABSTRACT FROM AUTHOR]

Italy, with 8000 km-long coastlines, ranks 15th among the world countries for coastal extension. Therefore, for Italy coastal hazard assessment is an essential challenge to protect anthropic structures (as many as 646 cities are found along the shoreline, and in addition one can count 734 harbors and more than 2200 km of maritime infrastructures) and to save human lives (about 30% of the Italian population permanently resides in coastal areas).We propose a case study of a hypothetical tsunamigenic massive landslide that might have occurred off Cape Rizzuto (eastern Calabria coast, Italy). Analyzing seismic profiles and the sea bottom morphology, we have identified clues suggesting the possible occurrence of a deep-seated submarine slide involving a volume of about 25 km3, whose movement could produce a tsunami with extremely high-impact on a local scale. If the occurrence of this landslide deposit is confirmed by additional studies, the potential landslide-triggered tsunami could affect 250 km of shore and about 440,000 people. The adopted approach includes the analysis of slope stability, the simulation of the landslide dynamics and the computation of the ensuing tsunami generation and propagation. First, we assess the peak ground acceleration, consistent with local seismicity and historical earthquakes, necessary to mobilize the submarine slope by using the minimum lithostatic deviation method. Then, we simulate the landslide movement by using the numerical model UBO-BLOCK1, whose results allow us to define the input for the tsunami generation. Lastly, we simulate the tsunami propagation by means of the numerical model UBO-TSUFD. All the cited numerical tools have been developed and are being maintained by the tsunami research team of the University of Bologna.This contribution is part of a broader effort aiming at assessing the tsunami hazard potentially affecting Calabria, and producing local maps of maximum wave heights on the coast is an essential step to assess potential damages and losses. [ABSTRACT FROM AUTHOR]

Background: Pancreatic cancer (PC) first-line therapy often consists of polychemotherapy regimens, but choosing a second-line therapy after disease progression, especially following first-line FOLFIRINOX, remains a clinical challenge. This study presents results from a large, multicenter, retrospective analysis of Italian patients with metastatic PC (mPC) treated with Nab-paclitaxel/Gemcitabine (AG) as second or later line of treatment. Main objective of the study is to identify prognostic factors that could inform treatment decisions., Methods: The study included 160 mPC patients treated with AG in 17 Italian institutions. AG was administered according to labelling dose, until disease progression, unacceptable toxicity or patient refusal. Variations in schedules, dose modifications, supportive measures, and response evaluation were determined by individual clinicians' practice., Results: AG was well-tolerated and exhibited promising clinical activity. The overall response rate (ORR) and the disease control rate (DCR) were 22.5% and 45.6%, respectively. Median progression-free survival (PFS) and overall survival (OS) were 3.9 and 6.8 months, respectively. Among the patients who received AG as a second-line therapy (n = 111, 66.9%), median PFS and OS were 4.2 and 7.4 months, respectively. Notably, in the 76 patients (68%) receiving AG after first-line FOLFIRINOX, an ORR of 19.7% and a DCR of 46.0% were observed, resulting in a median PFS of 3.5 and median OS of 5.7 months. The study identified specific clinical or laboratory parameters (LDH, NLR, fasting serum glucose, liver metastases, ECOG PS, and first-line PFS) as independent prognostic factors at multivariate level. These factors were used to create a prognostic nomogram that divided patients into three risk classes, helping to predict second-line OS and PFS., Conclusions: This study represents the largest real-world population of mPC patients treated with AG as a second or later line of therapy. It supports the feasibility of this regimen following first-line FOLFIRINOX, particularly in patients with specific clinical and laboratory characteristics who derived prolonged benefit from first-line therapy., (© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)

Aquaponics has witnessed global proliferation and a notable enhancement in sustainability in recent years. Consequently, it assumes paramount importance to delineate optimal locations for its implementation, in fact, the success of an aquaponic facility also depends on its geographical placement, necessitating consideration of many variables encompassing natural resources, socioeconomic factors, infrastructural availability and environmental constraints, whether natural or artificial. This paper focuses on the definition and test in the Emilia-Romagna region (Italy) of a GIS-based multi-criteria land suitability assessment model aimed at allowing the diffusion and environmental integration of innovative integrated multi-trophic aquaponic systems. The process has been implemented with a Weighted Linear Combination (WLC) model, where decisions and criteria were selected via a participatory mechanism involving experts in various fields. The region has been subdivided into 50 × 50 m grid cells, with each grid cell being associated with a value ranging from 0 to 8. In this context, a rating of 0 means unsuitability, while a rating of 1 denotes minimal suitability, and the highest rating of 8 designates maximal suitability. Notably, a substantial portion of the surveyed territory has been found to be completely unsuitable for the establishment of aquaponic facilities. More than 86.4% of the remaining suitable areas were rated 6, 7, or 8, affirming the overall favourability of the Emilia-Romagna region for aquaponic installations. Finally, the veracity and robustness of the results have been tested through a one-at-a-time sensitivity analysis, that has proven the appropriateness of the proposed model., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Daniele Torreggiani reports financial support was provided by PRIMA program (Partnership for research and innovation in the Mediterranean area)., (Copyright © 2023. Published by Elsevier B.V.)

Background: Quality of life (QoL) patient-reported outcomes (PROs) data from pivotal first-line trials in metastatic colorectal cancer (mCRC) are poor. The Valentino study showed that de-escalation to single-agent panitumumab after 4-month induction with panitumumab-FOLFOX is inferior to panitumumab-5-FU/LV in patients with RAS wild-type mCRC, although slightly reducing toxicity. We report QoL, a secondary end-point., Methods: PROs were assessed by European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core 30 (QLQ-C30), EORTC QLQ-CR29, EuroQol EQ-5D questionnaires, at baseline and every 8 weeks until disease progression. First two evaluations correspond to induction treatment (identical in both arms), while subsequent to maintenance. To describe QoL changes over time, mean changes from baseline at each time point were calculated in overall population. To compare maintenance between two arms, mean changes and proportion of improved/stable/worse patients versus baseline were compared for each item., Results: In arm A/B, 91.5%/92.0% of enrolled patients completed questionnaires at baseline. No significant differences in the two arms were reported in compliance, baseline scores and mean changes versus baseline for the three questionnaires during maintenance (24/32/40 weeks). Overall, mean changes versus baseline showed an early deterioration during induction with partial recovering during maintenance for global QoL, functional scales and several symptoms/items of QLQ-C30 (fatigue, nausea/vomiting, appetite loss, diarrhoea) and QLQ-CR29 (body image, dry mouth, hair loss, taste, faecal incontinence, sore skin), and EQ-5D Visual Analogue Scale (VAS) score., Conclusion: In patients with RAS wild-type mCRC, induction with oxaliplatin-containing chemotherapy plus anti-EGFRs induces a transient significant QoL deterioration. After induction phase, treatment deintensification determines an overall recovery of health-related QoL, besides the expected prevention of oxaliplatin-related neurotoxicity., Competing Interests: Conflict of interest statement F.P. reports receiving honoraria for speaker activities and participation in advisory boards from Sanofi SA, Amgen, Inc, Bayer AG, Merck-Serono, Roche, and Servier Laboratories. A.S.-B. reports participation in advisory boards for Amgen, Bayer and Sanofi. L.R. reports being related to this manuscript as a member of the advisory board and for panitumumab supply from Amgen; unrelated to this manuscript as consulting or advisory role from Lilly, Bayer, Baxter, Sirtex Medical, Italfarmaco, Sanofi, ArQule, Incyte, Ipsen, Exelixis, Celgene, Eisai, Hengrui, MSD; has also received lecture fees from AstraZeneca, AbbVie, Gilead, Roche; has received travel expenses from ArQule, Ipsen. A.Z. reports receiving honoraria for speaker activities and participation in advisory boards from Sanofi SA, Amgen, Inc, Bayer AG, Merck-Serono, and Roche. M.D.B. reports receiving honoraria for speaker activities and participation in advisory boards from Amgen, Inc, Roche, Eli Lilly and Company, Servier Laboratories. Incyte Corp, and Celgene Corporation. F.d.B. reports receiving honoraria for speaker activities and participation in advisory boards from Amgen, Inc, Roche, and Novartis International AG. No other disclosures were reported., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: MET overexpression/amplification has been associated with resistance to anti- epidermal growth factor receptor therapies in patients with metastatic colorectal cancer (mCRC). Combining tivantinib, an inhibitor of the MET receptor tyrosine kinase, and cetuximab may be effective in patients with epidermal growth factor receptor-resistant MET-high mCRC., Patients and Methods: This multicenter, single-arm, Simon 2-stage, phase II study enrolled patients with MET-high, KRAS wild-type mCRC, who were treated with ≥ 1 prior systemic therapy, with at least stable disease on the last treatment regimen containing cetuximab or panitumumab. Patients were enrolled if they presented tumor progression on cetuximab or panitumumab within 3 months before enrollment. Patients received tivantinib (360 mg twice daily) plus cetuximab (500 mg intravenously every 2 weeks). The primary endpoint was objective response rate; secondary endpoints included progression-free survival, overall survival, and safety. The treatment would be considered effective if ≥ 5 confirmed partial responses were observed among 41 patients., Results: In total, 41 patients were evaluated, 4 patients (9.8%) achieved an objective response, the median progression-free survival was 2.6 months (95% confidence interval, 1.9-4.2 months), and the median overall survival was 9.2 months (95% confidence interval, 7.1-15.1 months). Among 13 patients with tested MET amplification, 2 responding patients had MET amplification compared with none of the nonresponding patients. The most common grade ≥ 3 treatment-emergent adverse events were neutropenia (14.6%), skin toxicity (12.2%), and fatigue (9.8%)., Conclusion: Although the study did not meet its primary endpoint, efficacy results suggest some activity of the tested combination, with almost 10% of patients achieving objective response in a difficult-to-treat setting. Treatment-emergent adverse events were consistent with the known safety profile of tivantinib and cetuximab., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Aflibercept combined with FOLFIRI (folinic acid, 5-fluorouracil, irinotecan) as second-line treatment of metastatic colorectal cancer (mCRC) significantly improved survival compared with FOLFIRI alone in the pivotal VELOUR (aflibercept vs. placebo in combination with irinotecan and 5-fluorouracil in the treatment of patients with metastatic colorectal cancer after failure of an oxaliplatin-based regimen) trial. No quality-of-life assessment was performed in VELOUR; therefore, the ASQoP (Aflibercept Safety and Quality-of-Life Program) trial was designed to capture the safety and health-related quality of life (HRQL)., Patients and Methods: ASQoP was an international, open-label, single-arm trial evaluating the safety and HRQL of aflibercept combined with FOLFIRI administered in a real-life setting to 781 patients with mCRC, pretreated with an oxaliplatin-based regimen with or without bevacizumab. The Italian subset of ASQoP enrolled 200 patients from 28 institutions. The primary endpoint was safety; HRQL was a secondary endpoint, assessed by validated questionnaires (European quality of life 5-dimension instrument 3-level; European Organization for Research and Treatment for Cancer Quality of Life Questionnaire Core 30, version 3; and EORTC-CR29) at baseline, during treatment, and at the end of treatment., Results: The median age of the Italian ASQoP population was 63 years; the median number of aflibercept and FOLFIRI cycles was 7. Treatment-emergent adverse events were reported in 97.5% of patients. Hypertension (28.5%), neutropenia (27.5%; from laboratory data), asthenic conditions (20.0%), diarrhea (17.0%), and stomatitis (13.0%) were the most frequent (incidence, ≥ 5%) grade 3/4 toxicities. One toxic death occurred during the study period due to sepsis, without neutropenic complications. No significant worsening of HRQL was shown during treatment., Conclusion: Aflibercept combined with FOLFIRI was well tolerated when administered as second-line treatment for patients with mCRC in a real-life setting. It did not affect HRQL and showed similar rates of treatment-emergent adverse events as those observed in the VELOUR trial. No new safety signals were identified., (Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose Given the cumulative neurotoxicity associated with oxaliplatin, a shorter duration of adjuvant therapy, if equally efficacious, would be advantageous for patients and health-care systems. Methods The Three or Six Colon Adjuvant trial is an open-label, phase III, multicenter, noninferiority trial randomizing patients with high-risk stage II or stage III colon cancer to receive 3 months or 6 months of FOLFOX (fluorouracil, leucovorin, and oxaliplatin) or CAPOX (capecitabine plus oxaliplatin). Primary end-point is relapse-free survival. Results 3,759 patients were accrued from 130 Italian sites, 64% receiving FOLFOX and 36% CAPOX. Two-thirds were stage III. The median time of follow up was 62 months and 772 relapses or deaths have been observed. The hazard ratio (HR) of the 3 months versus 6 months for relapse/death was 1.14 (95% CI, 0.99 to 1.32; P [for noninferiority] = .514) and the CI crossed the noninferiority limit of 1.20. However, the absolute difference in 3-year RFS was 1.9% (95% CI, -0.7% to 4.4%). Counter-intuitively, while the RFS curves were similar for stage III (HR, 1.07; 95% CI, 0.91 to 1.26) and for CAPOX treated patients (HR, 0.98; 95% CI, 0.77 to 1.26), they were not for stage II and for FOLFOX treated patients, with HR of 1.41 (95% CI, 1.05 to 1.89) and 1.23 (95% CI, 1.03 to 1.46), respectively, favoring the 6 months of treatment. Conclusion The Three or Six Colon Adjuvant trial failed to formally show noninferiority of 3 versus 6 months of treatment to the predefined margin of 20% relative increase. The results depended on the adjuvant regimen and risk. For CAPOX, 3 months were as good as 6 months; for FOLFOX, 6 months added extra benefit. Counter-intuitively, the low-risk patients benefitted more than the high-risk population from the 6-month duration. The choice of regimen and duration should depend on patient characteristics and be balanced against the extra toxicity of longer therapy.

Background: Several randomized clinical trials (RCTs) have demonstrated the efficacy of trastuzumab-based adjuvant therapy in HER2-positive breast cancer (BC). However, RCT patients may not invariably be representative of patients routinely seen in clinical practice (CP). To address this issue, we compared the clinical and tumor features of RCT and CP patients with HER2-positive BC., Patients and Methods: From January to December 2012, 650 consecutive patients with HER2-positive early BC, treated in 36 different types of Italian healthcare facilities, were enrolled in this study. Age, treatment, tumor size (T), nodes (N), grade (G), estrogen receptor (ER) and progesterone receptor (PgR) status were prospectively collected in these CP patients. The same data were extracted from the main adjuvant trastuzumab RCTs and pooled using the random-effects model of DerSimonian and Laird. RCT and CP patients were compared by using the Cochran Q statistics., Results: Versus RCT patients, CP patients were more likely to be older than 50 years (65 vs. 49 %; p < 0.0001) and to have HR (ER and/or PgR)-positive (72 vs. 54 %; p < 0.0001) BC and less likely to have tumor >2 cm (T ≥ 2 cm 39 vs. 59 %; p < 0.0001), positive N (47 vs. 89 %; p < 0.0001) and a high G (61 vs. 67 %; p = 0.0241). CP patients more frequently received adjuvant endocrine therapy (70 vs. 57 %; p < 0.0003) and less frequently adjuvant chemotherapy (97 vs. 99.7 %; p < 0.0001)., Conclusions: Most tumor and clinical features differed significantly between CP and RCT patients. These data raise concerns about the applicability of RCT results to CP patients.

With the recent progress in predictive medicine several problems have emerged regarding the ethical aspects of genetic testing. The role of the doctor in communicating the consequences of such testing to the patient has become more important than ever in allowing the potential patient to make an informed decision.

Background: Early tumor shrinkage (ETS) and depth of response (DoR) predict overall survival (OS) in first-line trials of chemotherapy ± anti-EGFR monoclonal antibodies in metastatic colorectal cancer (mCRC). These associations and the predictive accuracy of response measurements for survival parameters were investigated in the phase III TRIBE trial of FOLFOXIRI plus bevacizumab (bev) versus FOLFIRI plus bev., Patients and Methods: A landmark approach was adopted to define the assessable population. The distribution of RECIST response rate, ETS and DoR was compared in the two arms. Associations between response measurements and progression-free survival (PFS), post-progression survival (PPS) and OS were tested by univariate and multivariate Cox models. Prediction performance of each factor was estimated by C-index., Results: A significantly higher percentage of patients in the FOLFOXIRI plus bev arm achieved ETS ≥20%, when compared with the control arm (62.7% versus 51.9%, P = 0.025). Also the DoR was significantly higher in the triplet plus bev arm (43.4% versus 37.8%, P = 0.003). Both ETS and DoR were associated with PFS, PPS and OS at the univariate analyses and in the multivariate models stratified for other prognostic variables. Both ETS and DoR were able to predict survival as accurately as RECIST response., Conclusion: FOLFOXIRI plus bev improves ETS and DoR when compared with FOLFIRI plus bev. Achieving rapid and deep tumor shrinkage consistently delays tumor progression and prolongs survival in patients treated with first-line chemotherapy plus bev. ETS is a promising and valuable end point for clinical trials' design deserving further investigation., (© The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

We investigated the prevalence of nocturnal eating (sleep-related eating disorder-SRED or night-eating syndrome-NES) in patients with restless legs syndrome (RLS). One hundred RLS patients living in Emilia-Romagna (Northern Italy) and 100 matched controls randomly selected from the general population received two telephone interviews, and were investigated for socio-demographic characteristics, general health status, and presence of nocturnal eating. Additionally, subjects underwent interviews for psychopathological traits [by means of the Eating Disorder Inventory-2 (EDI-2), the Maudsley Obsessive-Compulsive Inventory (MOCI), the Beck Depression Inventory (BDI)], excessive daytime sleepiness (EDS), and subjective sleep quality. Compared with controls, RLS patients had more frequently pathological MOCI scores (24% versus 10%, P = 0.03), used significantly more drugs for concomitant diseases and had more nocturnal sleep impairment and EDS. SRED was more prevalent in RLS patients than controls (SRED: 33% versus 1%, P < 0.001). Medication use and pathological MOCI scores were more prevalent in RLS patients with SRED than among RLS patients without SRED. Use of dopaminergic or hypnotic drugs for RLS was not correlated with the presence of SRED. We demonstrate an association between RLS and SRED. Prospective studies are needed to establish the mechanisms underlying such association and whether it is causal., ((c) 2009 Movement Disorder Society.)

The 125/2001, the national law that forbids the alcohol consumption by workers with work tasks having high accident risks, has been activated a year ago. We carried out in Lombardy a research to evaluate the state of enforcement of the law in firms having different work activities. We found a complete application of the law only in very few firms. We think that the Occupational Health doctors should give more attention to the problem of alcohol consumption at the work places, giving the firms their specific scientific and medical support, using the peculiar knowledge of our discipline.

Aims and Background: We evaluated the activity in terms of time to progression (TTP) of mitomycin C and capecitabine in patients with advanced colorectal cancer who progressed after 2 lines of chemotherapy., Methods: Patients with advanced colorectal cancer undergoing third-line chemotherapy after failure of 5-FU with CPT-11 or oxaliplatin-based chemotherapy regimens were treated with capecitabine and mitomycin C., Results: Sixty-one patients were enrolled in this study. The median age was 55 years (range, 26-78 years) and the male:female ratio 21:40. We observed partial remissions in 5 patients (8%), stable disease in 25 patients (40%) and progression of disease in 31 patients (52%). Median TTP was 3 months and median survival was 6 months. Global toxicity was mild and entirely acceptable. Grade 3-4 hematological toxicity occurred in 12 patients and grade 3-4 nonhematological toxicity in 5 patients., Conclusions: The combination of capecitabine and mitomycin C could represent an effective and manageable treatment option for colorectal cancer patients failing previous chemotherapy regimens.

The world population is getting increasingly older. In Western countries, lung cancer in the most frequent cancer and more than 50% of patients who contract non-small-cell lung cancer (NSCLC) are close to 70 years old. It is therefore fundamentally important that we identify an overall strategy of screening, diagnosis and therapy designed specifically for elderly patients. NSCLC research still has relatively little material dedicated exclusively to the elderly, but recently interest has been growing, possibly due to the positive results of the most recent trials (Elderly Lung Cancer Vinorelbine Study Group (ELVIS), Southern Italy Cooperative Oncology Group (SICOG), Multicenter Italian Lung Cancer in the Elderly Study (MILES)). In particular, the integration of geriatric and oncological information has led to better recognition of elderly candidates for more aggressive therapy which is usually reserved for younger patients, while recognizing more fragile patients who need only support therapy.

Background: 5-fluorouracil-based adjuvant chemotherapy after surgical resection of colon cancer is standard treatment. However, the choice of best delivery route--that is, systemic (i.e., intravenous or oral) or regional (i.e., intraportal, intraperitoneal, or hepatic arterial infusion)--has been controversial. In a randomized clinical trial of patients with colon cancer, we compared the benefits of chemotherapy delivered by these routes individually or in combination., Methods: From April 2, 1992, through April 30, 1998, 1084 eligible patients with Dukes' stage B or C colon carcinoma were randomly assigned: 369 patients to the IP regimen (continuous portal vein infusion of 5-fluorouracil at 500 mg/m2 of body surface daily and heparin at 5000 IU daily for 7 consecutive days, beginning on the day of surgery), 358 patients to the SY regimen (six 28-day courses of systemic leucovorin at 100 mg/m2 daily on days 1 through 5 followed by systemic bolus 5-fluorouracil at 370 mg/m2 daily on days 1 through 5, with treatment initiated 15-35 days after surgery), and 357 patients to the IP+SY regimen (the IP regimen followed by the SY regimen, with the same scheduling). Primary survival was analyzed with the log-rank statistic and a Cox multivariable regression model. All statistical tests were two sided., Results: At a median follow-up time of 99 months, 389 events (recurrences, second malignancies, or deaths) had occurred, and 361 patients died. Sites of first recurrences were similar among the three arms. At 5 years, overall and event-free survival rates were similar among those on the IP (74% and 68%, respectively), SY (78% and 71%), and IP+SY (73% and 67%) regimens. When compared with the group on the SY regimen, the risk for death associated with the IP regimen (hazard ratio [HR] = 1.05, 95% confidence interval [CI] = 0.82 to 1.36) was similar to that associated with the IP+SY regimen (HR = 1.12, 95% CI = 0.78 to 1.45) (P =.69), as were the risks for first event (HR = 1.07, 95% CI = 0.84 to 1.37 and HR = 1.10, 95% CI = 0.86 to 1.41, respectively) (P=.74)., Conclusion: Overall and event-free survival rates were similar in all three arms. The combined regimen was no better than either single regimen alone.